If the decay is too advanced and cannot be repaired with a synthetic filler, we can reconstruct your tooth with ceramic. Thanks to the digital technique we use this is often possible on the same day.
When
If a defect in the tooth caused by caries has become too large to be able to reconstruct it with a plastic filling in a stable manner in the long term, we nowadays like to fall back on modern computer-based techniques and manufacture so-called inlays or onlays for our patients.
With an inlay, we replace one or more cusps that are embedded directly into the natural tooth. An onlay, on the other hand, covers the entire chewing surface. Since this type of denture consists entirely of ceramic, the inherent stability compared to plastic fillings is significantly higher, so that we can often reconstruct even broken teeth and avoid dentures.
Treatment with an onlay is particularly recommended for teeth that have already had a root canal treatment. The reason for this is that teeth that have been treated with root canals are particularly sensitive and therefore have a high risk of fracture. Even if there are always cases in which a fracture on the tooth can unfortunately no longer be saved, it has meanwhile been scientifically proven that the risk of fractures is significantly reduced by an indirect restoration using an onlay. This can significantly improve the prognosis and durability of the root canal-treated tooth.
costs
Laboratory-made ceramic inlays or onlays costs between approx. CHF 1200.- and CHF 1650.- depending on size and location. At CEREC inlays and onalys the costs range between CHF 750.- and CHF 1150.- depending on size and location. Further information can be found in our price list.
How
Inlays and onlays belong to the so-called indirect restorations. But how are inlays used? Inlays and onlays are not modeled directly in the tooth like a filling and then hardened, but made indirectly in the dental laboratory or a computer-controlled milling machine from 100 % ceramic. The ceramic construction is then chemically bonded to the tooth substance using special cements. This bond is very strong and has good durability so that the reconstruction can last for many decades. According to scientific studies, the average survival time of indirect restorations (inlays, onlays, crowns, bridges) is approx. 25 years. With appropriate care, such a restoration can even last 40 years or more before it has to be renewed.
A box-shaped hole (cavity) is formed from the defect that has arisen (e.g. after the removal of caries) so that the inlay filling clings perfectly to the tooth. In order to restore a damaged tooth with an inlay or onlay, a conventional impression of the affected tooth is usually made using a precision impression material. If the defect is to be treated with a ceramic inlay, the dentist now determines the color of the tooth so that the material can be selected to match the patient's tooth color in the dental laboratory. The impression is then sent to the dental laboratory, where the actual restoration takes place. In order to generate an exact jaw model of the patient, iIn the dental laboratory, the impression is filled with a special hard stone. This makes the prepared defect visible and the ceramic can be manufactured individually to the shape of the patient.
In the classic procedure, the later wax inlay is then modeled and tested in an articulator (a dental device that simulates the patient's jaw and chewing situation). With the help of the wax model, a casting mold is made into which the material for the final inlay or onlay is poured (gold inlays, gold onlays). For ceramic inlays or ceramic onlays, the material is injected under high pressure and high temperature. Last but not least, the dental technician finely grinds and polishes the inlay blank.
After approx. 5-7 days, the finished inlay or onlay is back in our practice and can be glued to the tooth in a second session.
To insert the inlay or onlay, the dentist applies a special adhesive or fixing cement to the inlay filling and places it in the cavity. Afterwards, possible residues of the cement, which could cause gingivitis, are removed and the edges of the inlay filling are finely polished. Once the tooth has been ground in, chewing, speaking and swallowing work properly again.
Between the two sessions, the cavity of the diseased tooth is protected with a temporary filling made of a special plastic so that the patient can chew and eat normally. However, it is recommended that you avoid particularly sticky food and chewing gum in this provisional phase, as this can cause the provisional inlay or onlay to loosen in individual cases.
As an alternative to the conventional procedure, in some cases the inlay or onlay can also be made directly in the practice in one session. Instead of the conventional impression, a digital impression is taken with an intraoral scanner directly at the treatment chair. On the basis of this scan, the crown is milled from high-performance ceramic in our CEREC milling machine and inserted directly or after a sinter firing. This saves patients the cost of a temporary crown. In addition, a second treatment session can be dispensed with. Your treating dentist will be happy to explain to you whether this is possible in your particular case.
Tooth inlays and onlays made of ceramic have the advantage over conventional tooth fillings that they not only come closest to the natural tooth substance in terms of hardness, but also in color and appearance. Furthermore, ceramic inlays or onlays have a significantly longer shelf life, resilience and high biological compatibility than other tooth fillings and are therefore in many cases a good alternative for the prepared tooth.
More information about the different treatment options
While the inlay is particularly suitable for small to medium-sized tooth defects, a large part of the occlusal surface can be reconstructed with an onlay. As the onlay reaches over the cusps of the tooth, weakened tooth walls are strengthened. The inlay, on the other hand, is completely enclosed by tooth substance and is only used on teeth that are otherwise healthy.
Direct ceramic restorations such as CEREC inlays or onlays save time and often money. The ceramic that is milled directly and used within 1-2 hours is somewhat softer than a fired ceramic. D.Furthermore, this method is not recommended in dentistry for patients who have a tendency to crunch (bruxism) or clenching at night.
For such patients, we recommend restorations made from Emax or zirconium oxide ceramics. These can also be produced directly in the center. However, the treatment takes a little longer than a CEREC ceramic restoration due to the additional firing time of the ceramic during manufacture.
In the aesthetically visible area or for larger restorations such as bridges or attachments, we recommend having the restorations produced by a dental laboratory, as the aesthetic result of the restorations (inlay / onlay / veneer / crown) is usually even better than that of the dental technician is directly milled.
